Asma Badani (not her real name), 30, has been trying to overcome her heroin addiction since last year, but with little success.
In a last bid for recovery, she recently checked in to the health ministry’s National Centre for the Rehabilitation of Addicts (NCRA), located just outside the Jordanian capital, Amman.
Now on her second day of a two-week detoxification programme, Badani apologises for not being able to articulate herself clearly as she explains how she got hooked on the drug two years ago, in the wake of her husband’s death.
“I was very depressed”, explains Badani. “Then, through friends who were already using, I started taking heroine.”
After formal admission procedures, including physical, neurological and psychiatric examinations, Badani began the initial phase of drug treatment – detoxification. This is meant to help patients overcome the typically intense withdrawal symptoms associated with hyper-addictive narcotics like heroin.
According to project coordinator Ernest Robello of the United Nations Office on Drugs and Crime (UNODC), which helped develop the NCRA, opiates are never used in the detoxification process. “The use of psychoactive drugs in this stage is very restricted,” said Robello.
He added that, in the case that additional medical specialties are needed, patients can receive assistance from the NCRA staff.
If Badani waits out the full detoxification phase, she will then undergo another four weeks of psychological counselling, aimed at enhancing the personal welfare of the patient and aiding in his or her social rehabilitation.
A number of methods are used to these ends, including group therapy; relapse-prevention sessions; social skills training; health education lectures; and recreational activities.
Patients also participate in group sessions with former drug abusers.
Once they have completed treatment, regular follow-up sessions must be scheduled in order to prevent relapse. “Patients are required to visit the NCRA at least once a week, and in cases of emergency,” said Robello.
A male environment
The centre’s mission is simple: to provide treatment and rehabilitation services for drug abusers, regardless of gender.
But while the NCRA first opened in 2001, it wasn’t until last February that the centre could open a ward specifically for female patients in need of counselling, for sexual, and physical-abuse as well as for addiction problems.
This was due to a lack of staff.
Badani, therefore, has been one of a very few female drug addicts in Jordan to have sought help at the NCRA.
“We have just one female patient at the moment,” noted NCRA director Dr Jamal Anani. “And our female staff is limited.”
An assessment of drug abuse in Jordan commissioned by the UNODC in 2000 revealed that drug use among females was seven times less frequent than among males.
However, a recently UNODC conducted Global School Health Survey indicated that, while the use of drugs like alcohol and tobacco was considerably higher among Jordanian males, the use of sleeping pills and inhalants was higher among females.
Since its inception, the NCRA, developed in collaboration with the anti-narcotics department of the police, has admitted a total of 882, overwhelmingly male, patients. According to centre officials, most patients’ ages range from between 20 and 45 years-old.
Along with Badani, some 40 male drug abusers are currently receiving treatment at the NCRA.
A lack of data
Gathering dependable information on the phenomenon remains problematic, as drug use, like the subject of sexually-transmitted diseases, remains taboo in this generally conservative society.
“Drug use is regarded as a ‘hidden’ problem,” said Robello, adding that this has made reliable statistics hard to come by.
Alcohol tops the NCRA’s list of most commonly abused narcotics, considered the only data available on drug addiction in Jordan. This is followed by pharmaceuticals, such as sedatives or antidepressants, heroine and solvents, such as industrial glues and paints.
According to Jordan’s anti-narcotics department, hashish, a marijuana derivative, had been the most commonly reported illicit narcotic in the country up until the mid-1990s. Since then, however, the interior ministry has reported rising cases of heroin.
Ecstasy pills have also been seized by the authorities with greater frequency, and some predict the tablets could represent a new trend in local drug consumption.
Most of the hashish comes from Turkey and Lebanon and the heroin from Afghanistan and Syria, according to Jordanian police.
In an effort to gather more information on consumption patterns, the government and the UNODC recently launched the Jordanian Drug Information Network, dubbed JorDIN.
Network planners hope to utilise drug treatment centres, arrest and prison records, mortality records and population surveys as primary sources.
According to Robello, one of the most important side benefits of the programme is the “demystification” of the drug addiction phenomenon and the change of attitudes regarding treatment.
“Thanks to this project, we can begin talking about formerly taboo subjects, such as HIV/AIDS and sexual attitudes,” he said.
The centre is now offering treatment for drug abusers living with HIV, in cooperation with the government-run National Aids Programme. At present there is one person at the centre receiving such care.
“This requires continuous and specialised training of the NCRA staff in HIV/AIDS topics,” said Robello.
Drug abuse prevention and treatment within the penal system is also among the UNODC’s top priorities. “It’s essential to develop a strategic system of treatment, capable of dealing with all stages of drug abuse, as well as related HIV/AIDS issues, within correctional institutions,” Robello added.
According to the UNODC, frequent episodes of violence and homosexual sex among prisoners, as well as the sharing of equipment like needles, greatly increases the risk of HIV transmission.
Much work ahead
While the UNODC and its rehabilitation centre have made considerable strides both in terms of treatment and awareness, those involved concede that much work remains to be done.
Robello emphasised the need for a network of outreach units nationwide and the establishment of halfway houses for discharged patients. “Early intervention and aftercare programmes need to be coordinated with healthcare centres, NGOs and other community-based services,” he said.
He concluded by pointing out that, so far, despite a proposal in 2001 for the creation of seven outreach units strategically situated throughout Jordan, only one has been established.
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions